Assessing TMS-induced D and I waves with spinal H-reflexes.

Assessing TMS-induced D and I waves with spinal H-reflexes.
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使用脊髓 H 反射评估 TMS 诱导的 D 波和 I 波

DOI:
10.1152/jn.00671.2017
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发表时间:
2018
影响因子:
2.5
通讯作者:
Leukel C
Leukel C
中科院分区:
医学3区
文献类型:
--
作者:
Niemann N;Wiegel P;Kurz A;Rothwell JC;Leukel C

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运动皮层的经颅磁刺激 (TMS) 会产生一系列下降的齐射波,称为 D(直接)波和 I(间接)波。在本研究中,我们质疑脊髓 H 反射是否可用于解析 TMS 的 D 波以及早期和晚期 I 波。因此,我们探讨了 D 波和 I 波到达脊髓水平时的 H 反射促进,从而改变了先前已证明对诱发 D 波和不同 I 波具有选择性影响的 TMS 参数。我们改变了 TMS 强度和电流方向,并应用了称为短间隔皮质内抑制 (SICI) 的双脉冲范例。实验在手臂的桡侧腕屈肌 (FCR) 和腿部的比目鱼肌 (SOL) 中进行。有两个主要发现:1)在 FCR 中,H 反射促进显示出与诱发 D 波和 I 波的变化相对应的 TMS 参数改变的特征调制; 2) SOL 中的 H 反射没有,可能是因为其他脊髓回路的干扰增加。因此,这项研究最重要的结果是,在 FCR 中,H 反射与 TMS 相结合似乎是剖析 TMS 诱导的 D 波和 I 波的有用技术。新的和值得注意的与病理生理学和运动控制中的皮质脊髓功能相关的问题需要复杂的技术来提供有关皮质脊髓机制的信息。我们引入了一种无创电生理学技术,通过剖析经颅磁刺激 (TMS) 的 D 波和 I 波,该技术可能有助于更详细地描述此类机制。基于脊髓 H 反射和桡侧腕屈肌 TMS 的结合,该技术被证明可以测量改变 TMS 参数对 D 波和 I 波的选择性影响。
Transcranial magnetic stimulation (TMS) of motor cortex produces a series of descending volleys known as D (direct) and I (indirect) waves. In the present study, we questioned whether spinal H-reflexes can be used to dissect D waves and early and late I waves from TMS. We therefore probed H-reflex facilitation at arrival times of D and I waves at the spinal level and thereby changed TMS parameters that have previously been shown to have selective effects on evoked D and different I waves. We changed TMS intensity and current direction and applied a double-pulse paradigm known as short-interval intracortical inhibition (SICI). Experiments were conducted in flexor carpi radialis (FCR) in the arm and soleus (SOL) in the leg. There were two major findings:1) in FCR, H-reflex facilitation showed characteristic modulations with altered TMS parameters that correspond to the changes of evoked D and I waves; and2) H-reflexes in SOL did not, possibly because of increased interference from other spinal circuits. Therefore, the most significant outcome of this study is that in FCR, H-reflexes combined with TMS seem to be a useful technique to dissect TMS-induced D and I waves.NEW & NOTEWORTHYQuestions that relate to corticospinal function in pathophysiology and movement control demand sophisticated techniques to provide information about corticospinal mechanisms. We introduce a noninvasive electrophysiological technique that may be useful in describing such mechanisms in more detail by dissecting D and I waves from transcranial magnetic stimulation (TMS). Based on the combination of spinal H-reflexes and TMS in the flexor carpi radialis muscle, the technique was shown to measure selective effects on D and I waves from changing TMS parameters.
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